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一项为患有慢性疼痛的青少年量身定制的正念训练计划:可行性、可接受性及初步结果

A Mindfulness Program Adapted for Adolescents With Chronic Pain: Feasibility, Acceptability, and Initial Outcomes.

作者信息

Ruskin Danielle A, Gagnon Michelle M, Kohut Sara A, Stinson Jennifer N, Walker Kathryn S

机构信息

*The Hospital for Sick Children †Graduate Program in Psychology, York University ‡Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, Toronto, ON, Canada.

出版信息

Clin J Pain. 2017 Nov;33(11):1019-1029. doi: 10.1097/AJP.0000000000000490.

Abstract

OBJECTIVES

Pediatric chronic pain is a major health issue that can lead to significant interference in daily functioning. Mindfulness-based interventions (MBI's), which emphasize acceptance rather than control of pain, have gained increasing attention as a viable treatment option among adults with chronic pain. The effectiveness of MBIs for chronic pain in pediatric populations remains largely unknown. This prospective pre-post interventional study was conducted to examine the feasibility, acceptability, and initial effectiveness of an 8-week group MBI adapted for adolescents (MBI-A) with chronic pain.

MATERIALS AND METHODS

Self-report measures assessing pain characteristics, anxiety, depression, disability, pain catastrophizing, perceived social support, mindfulness, and pain acceptance were administered at baseline, postintervention, and at a 3-month follow-up. In addition, session data were collected to assess each session's impact on patients' coping with pain and stress, body awareness, and sense of feeling less alone.

RESULTS

In total, 42 consecutive patients in a tertiary care chronic pain clinic met eligibility criteria to participate in the MBI-A group. Of these, 21 participated. A treatment completion rate of 90.5% was observed. Between session mindfulness practice was reported by 77% of participants. Participants were highly satisfied with the MBI-A and all participants reported they would recommend the group to a friend. Improvements in pain acceptance were observed between baseline and the 3-month follow-up, in domains of Pain Willingness and Activity Engagement. Session data revealed improved body awareness and improved ability to cope with stress across sessions.

DISCUSSION

The MBI-A is a feasible, well-received intervention for adolescents with chronic pain conditions. Findings support the need for further investigation of the efficacy of MBI-A through randomized-controlled trials.

摘要

目的

儿童慢性疼痛是一个重大的健康问题,会对日常功能造成严重干扰。基于正念的干预措施(MBI)强调接纳而非控制疼痛,作为慢性疼痛成人患者可行的治疗选择,已越来越受到关注。MBI对儿童慢性疼痛的有效性在很大程度上仍不明确。本前瞻性干预前后研究旨在检验一种为慢性疼痛青少年(MBI-A)改编的为期8周的团体MBI的可行性、可接受性和初步有效性。

材料与方法

在基线、干预后和3个月随访时,采用自我报告测量方法评估疼痛特征、焦虑、抑郁、残疾、疼痛灾难化、感知社会支持、正念和疼痛接纳情况。此外,收集课程数据以评估每次课程对患者应对疼痛和压力、身体意识以及减少孤独感的影响。

结果

一家三级护理慢性疼痛诊所共有42名连续患者符合参与MBI-A组的资格标准。其中,21名患者参与。观察到治疗完成率为90.5%。77%的参与者报告在课程之间进行了正念练习。参与者对MBI-A高度满意,所有参与者都表示会向朋友推荐该团体。在基线和3个月随访之间,在疼痛意愿和活动参与领域观察到疼痛接纳情况有所改善。课程数据显示,各课程之间身体意识有所改善,应对压力的能力有所提高。

讨论

MBI-A是一种对患有慢性疼痛的青少年可行且广受好评的干预措施。研究结果支持通过随机对照试验进一步研究MBI-A疗效的必要性。

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